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Effect of tranexamic acid administration time on blood product use in urban trauma patients
- Source :
- American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists. 77(Supplement_2)
- Publication Year :
- 2020
-
Abstract
- Purpose To evaluate the effect of time to tranexamic acid administration on blood product usage in trauma patients and to assess the potential benefit of initiating a protocol for field administration by ground ambulance personnel. Methods Adult patients with traumatic injuries who received 1 g of tranexamic acid during the period January 2014 through June 2016 were retrospectively identified via review of automated dispensing cabinet and electronic medical record data and cross-referencing with the New Mexico Trauma Registry. Exclusion criteria included tranexamic acid use for nontrauma indications, previous admission for trauma during the study period, and a lack of pertinent information regarding the time, type, or severity of trauma in available records. The primary outcome was blood product use (aggregate of units of platelets, packed red blood cells [pRBCs], and fresh frozen plasma [FFP]) in the first 24 hours of hospital admission. Results The analysis included 107 patient cases, with a median transport time of 20 minutes (range, 7-103 minutes); 73% of reported transport times were less than 30 minutes. All patients received a loading dose of tranexamic acid in the hospital, with the exception of 2 patients who received tranexamic acid in the field. Administration of a tranexamic acid loading dose was documented within 3 hours for 90.7% of patients, with a mean time to administration of 91.9 minutes. A mean (SD) total of 14.8 (16.0) units of blood products (range, 0-91 units) were administered, consisting of a mean (SD) of 8.0 (8.4) units of pRBCs (range, 0-48 units), 5.6 (7.5) units of FFP (range, 0-38 units), and 1.2 (1.7) units of platelets (range, 0-7 units). Time to tranexamic acid administration did not affect blood product usage in the first 24 hours of admission after adjusting for potential confounders. Conclusion Earlier administration of tranexamic acid was not associated with a decrease in use of blood products. This finding, paired with the relatively short ground transport times typical for our institution, makes it unlikely that field administration of tranexamic acid would benefit the evaluated patient population.
- Subjects :
- Adult
Male
Time Factors
Adolescent
Urban Population
Transport time
Loading dose
03 medical and health sciences
Young Adult
0302 clinical medicine
Blood product
Emergency medical services
medicine
Humans
Blood Transfusion
030212 general & internal medicine
Aged
Retrospective Studies
Pharmacology
Aged, 80 and over
Administration time
business.industry
Health Policy
030208 emergency & critical care medicine
Middle Aged
Antifibrinolytic Agents
Tranexamic Acid
Anesthesia
Female
Fresh frozen plasma
business
Packed red blood cells
Tranexamic acid
medicine.drug
Subjects
Details
- ISSN :
- 15352900
- Volume :
- 77
- Issue :
- Supplement_2
- Database :
- OpenAIRE
- Journal :
- American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
- Accession number :
- edsair.doi.dedup.....42d771c08190c7cec6ff5422a5f2f251